The New York State legislature held a daylong hearing Tuesday on a proposal to enact single-payer health care in New York.

The New York State legislature held a daylong hearing Tuesday on a
proposal to enact single-payer health care in New York. Supporters and
opponents debated whether it’s the answer to the state’s health care
gaps.

Assembly Health Committee Chair Richard Gottfried, a
Democrat and prime sponsor of the legislation, known as the New York
Health Act, laid out the problem. Millions of New Yorkers have some form
of health coverage, he said. But many still face financial obstacles
from private insurance companies in getting the care they need, because
of unaffordable co-pays or coverage denials.

“Either we say ‘that’s not acceptable but oh, that’s too bad’, or we do something about it,” Gottfried said.

Dr.
Mitch Katz is head of the New York City Health and Hospitals
Corporation, which oversees public hospitals in New York. He supports
single-payer health care for the state. He says in his practice, he
routinely encounters glaring holes in the private health insurance
system.

“We’re currently in mediation with a for-profit insurance
company that says that a three-year-old boy brought to one of our
emergency rooms with a fever of 103 and unresponsive should have been
treated as an outpatient,” Katz said. “No responsible doctor would have
sent that child home.”

He says another patient at his public
clinic, a 60-year-old man, came to him after going to the hospital
emergency room with breathing problems. The symptoms could have easily
been alleviated with the use of an inhaler, but the insurance company
required a $60 copay, more than what the man could afford. He expects
the man will eventually end up in the emergency room again.

Democratic
Assemblyman Phil Steck, a longtime supporter of single payer health
care, says individual New Yorkers and businesses already pay many hidden
costs associated with health care. Speaking outside the hearing, Steck
says the majority of county property taxes go to fund the Medicaid
program, businesses and their employees pay a fee for Medicare, and
workers compensation insurance. He says even a portion of auto insurance
goes to cover health care costs.

“The question is are we going
to pay more or less in single-payer system,’ said Steck, who believes
there would be a 20% reduction in costs, when you “cut out all that
overhead.”

A Rand Corporation study
in August 2018 found that total health care spending would be slightly
lower under the plan, but it would require $139 billion in additional
state revenue to make the transition. That’s an amount that some state
lawmakers, including Democratic Governor Andrew Cuomo, say is too high.

The
Rand study also found that employers would ultimately pay less money
under a payroll tax in the measure than they currently pay to health
insurance companies for premiums.

Opponents include business
groups, and many hospitals, as well as some labor unions. Kevin Dahill
is with the Suburban Hospital Alliance, which represents hospitals in
nine suburban New York counties. He says single-payer health care would
“unquestionably” result in the closure of hospitals, because the
reimbursement for services could be set at the current rates for
Medicare and Medicaid, which pay about 80% of the actual cost of care.
He says that’s not enough to pay all of a hospital’s expenses.

“We
take care of those patients at a financial loss, that’s only made up by
way of our negotiation with the private insurers,” said Dahill.

Dahill
says there would also be a significant loss of jobs, and he believes
many workers who help patients and hospitals navigate the private
insurance process would be eliminated. He says if single-payer were
enacted, New York’s entire private insurance industry would be wiped
out, causing a negative “ripple effect” in the state’s economy.

Dahill
acknowledges there are significant problems with New Yorkers getting
adequate health care. But he believes they can be fixed through the
current system. He says his hospitals have been talking to the
organization that represents New York’s private insurers, known as the
Health Plan Association.

“Some of those issues can and should be
addressed,” Dahill said. “Working together with the Health Plan
Association, we will find ways, in my opinion, to address some of those
issues.”

An earlier version of the New York Health Act was
approved in the State Assembly, long led by Democrats. Even though
Democrats are in charge of the Senate now, and there are several
sponsors, it’s likely to take a bit longer to for a vote to be held. The
Senate sponsor, Democrat Gustavo Rivera, says he plans several more
hearings on single-payer health care, which will occur after this year’s
legislative session ends later in June.

WELCOME!

I represent Chelsea, Hell’s Kitchen, Midtown, and parts of Murray Hill and the Lincoln Center area in the State Assembly. I have been chair of the Assembly Health Committee since 1987. During off hours, I like to write Chinese calligraphy.